Ferrous fumarate is an iron compound that is used in the prevention and treatment of iron-deficient anaemia. Folic acid is a vitamin B that is used in the prevention and treatment of folate-deficient state. They are used together in pregnant women (2nd and 3rd trimesters) for the prevention of iron deficiency and megaloblastic anaemia of pregnancy.

Absorption
Ferrous fumarate: Absorption takes place mainly in the duodenum and jejunum; aided by gastric acid secretion. Folic acid: Absorption takes place mainly in the proximal part of the small intestine.

Distribution
Ferrous fumarate: Ferrous iron passes through the GI mucosal cells, bind to transferrin and is then transported to the bone marrow and incorporated into haemoglobin. Folic acid: Extensively bound to plasma proteins.

Metabolism
Folic acid: Largely metabolised in the liver.

Excretion
Ferrous fumarate: Mainly through the faeces and desquamation of cells e.g. skin, hair or GI mucosa. Folic acid: Mainly excreted in the urine.

Information Not Available

GI discomfort, anorexia, nausea, vomiting, constipation, diarrhoea. Stool darkening may occur.

Overdosage
Acute poisoning in young children is especially dangerous. Symptoms: Abdominal pain, vomiting and diarrhoea. CV collapse with coma may follow. In severe cases, deterioration may occur involving diffuse vascular congestion, pulmonary oedema, convulsions, anuria, hypothermia, severe shock and metabolic acidosis. Treatment includes inducing vomiting and gastric lavage. In severe cases, parenteral desferrioxamine may be used.

Avoid use in patients with active peptic ulcer, repeated blood transfusion, regional enteritis and ulcerative colitis. Caution when used in patients with folate-dependent tumours. Not recommended for use during 1st trimester of pregnancy.

Concurrent admin may reduce the efficacy of fluoroquinolones, levodopa, carbidopa, thyroxine and bisphosphonates. Iron may reduce the absorption of penicillamine by forming complexes. Concurrent admin with tetracycline may lead to reduced absorption of tetracycline and iron. Antacids may reduce the absorption of iron. Serum levels of anticonvulsants may be reduced by folic acid.

Information Not Available

Oral
Prophylaxis of iron deficiency in pregnancy
Adult: Each tablet containing ferrous fumarate 322 mg and folic acid 0.35 mg. For pregnant women from 13th weeks of gestation onwards: 1 tablet daily.

Information Not Available

Caution when used during pregnancy

Information Not Available

Information Not Available

Information Not Available

Paroxysmal nocturnal haemoglobinuria, haemosiderosis, haemochromatosis.

Oral
Store <25°C.

Information Not Available